Neuromuscular Unit, Institute of Molecular Medicine, University of Lisbon, Lisbon, Portugal.
Muscle Nerve. 2012 Sep;46(3):341-5. doi: 10.1002/mus.23313.
Some patients with amyotrophic lateral sclerosis (ALS) die suddenly despite normal nocturnal pulse oximetry (NPO), possibly due to dysautonomia.
Forty-four ALS patients without other medical conditions were studied. Heart rate variability was assessed through finger oximetry. The heart rate coefficient of variation (HR CV) was evaluated during nocturnal sleep. All patients were investigated at study entry (T1); 13 were tested 4 months later (T2), and 21 patients were investigated a further 24 months after entry (T3). Only recordings obtained from patients with normal NPO were accepted.
HR maximal, minimum, and median values remained stable. HR CV was similar between T1 and T2, but it decreased significantly at T3 (P < 0.01). Very low values were observed in 4 patients at T3 (HR CV <0.20), and 3 died suddenly within the following 2 months, despite normal NPO.
Low HR CV is a potential marker of prognosis in ALS.
尽管夜间脉搏血氧饱和度（NPO）正常，一些肌萎缩侧索硬化症（ALS）患者仍会突然死亡，这可能与自主神经功能障碍有关。
研究了 44 名无其他疾病的 ALS 患者。通过指套血氧仪评估心率变异性。在夜间睡眠期间评估心率变异系数（HR CV）。所有患者均在研究开始时（T1）接受检查；其中 13 名患者在 4 个月后（T2）接受了检查，21 名患者在进入研究后 24 个月（T3）接受了检查。仅接受 NPO 正常的患者的记录。
HR 最大值、最小值和中位数保持稳定。T1 和 T2 之间的 HR CV 相似，但在 T3 时显著降低（P < 0.01）。在 T3 时，有 4 名患者的 HR CV 值非常低（HR CV <0.20），其中 3 名在随后的 2 个月内突然死亡，尽管 NPO 正常。
低 HR CV 是 ALS 预后的潜在标志物。
